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1.
J Res Health Sci ; 20(3): e00488, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-33169720

RESUMO

BACKGROUND: COVID-19 is a new viral disease with a rapid outbreak. Pregnant women are at a higher risk of contracting viral infections including COVID-19. We aimed to evaluate the clinical course and risk factors of pregnant women diagnosed with COVID 19 in Hamadan Province, west of Iran. STUDY DESIGN: A retrospective cohort study. METHODS: The convenience sampling was performed using 50 papers and electronic files of pregnant women diagnosed with COVID-19 according to the WHO's temporary guidelines. They were hospitalized in health centers and clinics of Hamadan Province. The data-collecting tool employed was a researcher-made questionnaire. The data were analyzed via SPSS software version 19. RESULTS: The mean age of pregnant women with COVID 19 was estimated to be 29.20 ± 5.8 yr and their average gestational age estimated to be 28.8 ± 8.20 weeks. About 32% of them had an underlying disease, 32% a history of influenza, and 40% recently traveled to infected areas. The most common findings were CT scans and multiple mottling and ground-glass opacity chest radiology. The most common symptoms were fever, cough, and shortness of breath. About 8% of the women required ICU hospitalization and the average length of hospital stay was 4.04 ± 2.38 and 29% had premature births. Moreover, 28% of infected mothers had a normal delivery and 20% had a cesarean section. CONCLUSION: Early diagnosis of Covid-19 disease is essential in pregnant women. Because there is a possibility of worsening complications in the mother and fetus.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Betacoronavirus , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Tosse/epidemiologia , Tosse/etiologia , Demografia , Dispneia/epidemiologia , Dispneia/etiologia , Feminino , Febre/epidemiologia , Febre/etiologia , Hospitalização , Humanos , Recém-Nascido , Irã (Geográfico)/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X , Viagem , Adulto Jovem
2.
PLoS One ; 15(11): e0241470, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33152043

RESUMO

This study described the epidemiology of 487 confirmed coronavirus disease 2019 (COVID-19) cases in Sichuan province of China, and aimed to provide epidemiological evidence to support public health decision making. Epidemiological information of 487 COVID-19 cases were collected from the official websites of 21 districts (including 18 cities, 3 autonomous prefecture) health commissions within Sichuan between 21st of January 2020 to 17th of April 2020. We focus on the single-day diagnosis, demographics (gender and age), regional distribution, incubation period and symptoms. The number of single-day confirmed COVID-19 cases reach a peak on January 29 (33 cases), and then decreased. Chengdu (121 cases), Dazhou (39 cases) Nanchong (37 cases) and Ganzi Tibetan Autonomous Prefecture (78 cases) contributed 275 cases (56.5% of the total cases) of Sichuan province. The median age of patients was 44.0 years old and 52.6% were male. The history of living in or visiting Hubei, close contact, imported and unknown were 170 cases (34.9%), 136 cases (27.9%), 21 cases (4.3%) and 160 cases (32.9%) respectively. The interval from the onset of initial symptoms to laboratory diagnosis was 4.0 days in local cases, while that of imported cases was 4.5 days. The most common symptoms of illness onset were fever (71.9%) and cough (35.9%). The growth rate of COVID-19 in Sichuan has significantly decreased. New infected cases have shifted from the living in or visiting Wuhan and close contact to imported. It is necessary to closely monitor the physical condition of imported cases.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , China/epidemiologia , Tosse/epidemiologia , Feminino , Febre/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pandemias , Adulto Jovem
3.
BMC Infect Dis ; 20(1): 838, 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183252

RESUMO

BACKGROUND: A functioning Viral Haemorrhagic Fever (VHF) surveillance system in countries at risk for outbreaks can reduce early transmission in case of an outbreak. Surveillance performance depends on the application of suspect case definitions in daily clinical practice. Recommended suspect case criteria during outbreaks are designed for high sensitivity and include general symptoms, pyrexia, haemorrhage, epidemiological link and unexplained death in patients. Non-outbreak criteria are narrower, relying on the persistence of fever and the presence of haemorrhagic signs. METHODS: This study ascertains VHF suspect case prevalence based on outbreak and non-outbreak criteria in a Guinean regional hospital for a period of three months. The study further describes clinical trajectories of patients who meet non-outbreak VHF suspect case criteria in order to discuss challenges in their identification. We used cross-sectional data collection at triage and emergency room to record demographic and clinical data of all admitted patients during the study period. For the follow-up study with description of diagnostic trajectories of VHF suspect cases, we used retrospective chart review. RESULTS: The most common symptoms of all patients upon admission were fever, tiredness/weakness and abdominal pain. 686 patients met EVD outbreak criteria, ten adult patients and two paediatric patients met study-specific non-outbreak VHF suspect case criteria. None of the suspect cases was treated as VHF suspect case and none tested positive for malaria upon admission. Their most frequent discharge diagnosis was unspecific gastrointestinal infection. The most common diagnostic measures were haemoglobin level and glycaemia for both adults and for children; of the requested examinations for hospitalized suspect cases, 36% were not executed or obtained. Half of those patients self-discharged against medical advice. CONCLUSIONS: Our study shows that the number of VHF suspect cases may vary greatly depending on which suspect case criteria are applied. Identification of VHF suspect cases seems challenging in clinical practice. We suggest that this may be due to the low use of laboratory diagnostics to support certain diagnoses and the non-application of VHF suspect case definitions in clinical practice. Future VHF suspect case management should aim to tackle such challenges in comparable hospital settings.


Assuntos
Surtos de Doenças , Ebolavirus/genética , Serviço Hospitalar de Emergência , Doença pelo Vírus Ebola/diagnóstico , Doença pelo Vírus Ebola/epidemiologia , Centros de Atenção Terciária , Triagem/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Febre/diagnóstico , Febre/epidemiologia , Seguimentos , Guiné/epidemiologia , Doença pelo Vírus Ebola/virologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto Jovem
4.
Virulence ; 11(1): 1443-1452, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33108255

RESUMO

The diagnosed COVID-19 cases revealed that the incubation periods (IP) varied a lot among patients. However, few studies had emphasized on the different clinical features and prognosis of patients with different IP. A total of 330 patients with laboratory-confirmed COVID-19 were enrolled and classified into immediate onset group(IP<3 days, I group, 57 cases) and late onset group(IP>10 days, L group, 75 cases) based on IP. The difference of clinical characteristics and prognosis of the two groups were compared. There were more patients with fever in I group than in L group(P = 0.003), and counts of all the total lymphocytes, total T lymphocytes, CD4 + and CD8 + T lymphocytes were significantly different between the two groups(all P < 0.01). Besides, patients in L group had more GGOs in CT scan than I group and there were more patients in I group receiving antibiotic treatment than in L group(P < 0.001). For disease aggravation, the median CT scores were comparable between the two groups, but individually, there were more patients with increased CT score during hospitalization in I group than in L group. The aggravation incidence of CT presentation was 21.1% in I group, significantly higher than L group(8.0%, P = 0.042). Multivariable COX models suggested that IP was the only independent factors for CT aggravation. Conclusively, patients with different IP were different in clinical symptoms, laboratory tests, and CT presentations. Shorter IP was associated with the aggravation of lung involvement in CT scan.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Período de Incubação de Doenças Infecciosas , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Adulto , Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/diagnóstico por imagem , Progressão da Doença , Feminino , Febre/epidemiologia , Febre/patologia , Hospitalização , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/diagnóstico por imagem , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
5.
J Infect Public Health ; 13(11): 1639-1644, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33004305

RESUMO

INTRODUCTION: The ongoing pandemic of the coronavirus disease 2019 (COVID-19) is a global health concern. It has affected more than 5 million patients worldwide and resulted in an alarming number of deaths globally. While clinical characteristics have been reported elsewhere, data from our region is scarce. We investigated the clinical characteristics of mild to moderate cases of COVID-19 in Saudi Arabia. METHODS: This is a descriptive, cross-sectional study. Data of 401 confirmed COVID-19 patients were collected from 22 April 2020 to 21 May 2020 at five tertiary care hospitals in Riyadh, Saudi Arabia. The patients were divided into four groups according to age, Group 1: 0-<18 years, Group 2: 18-<50 years, Group 3: 50-60 years, and Group 4: >60 years; and their clinical symptoms were compared. RESULTS: The median (IQR) age in years was 10.5 (1.5-16) in group I, 34 (29-41) in group II, 53 (51-56) in group III, and 66 (61-76) in group IV. Most patients were male (80%, n = 322) and of Arabian or Asian descent. The median length of stay in the hospital was 10 (8-17) days (range 3-42 days). The most common symptoms were cough (53.6%), fever (36.2%), fatigue (26.4%), dyspnea (21.9%), and sore throat (21.9%). Hypertension was the most common underlying comorbidity (14.7%), followed by obesity (11.5%), and diabetes (10%). Hypertensive patients were less likely to present with shortness of breath, cough, sputum, diarrhea, and fever. CONCLUSION: There was no significant difference in the symptoms among different age groups and comorbidities were mostly seen in the older age group. Interestingly, hypertensive patients were found to have milder symptoms and a shorter length of stay. Further larger collaborative national studies are required to effectively understand clinical characteristics in our part of the world to efficiently manage and control the spread of SARS-CoV-2.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pesquisa Qualitativa , Adolescente , Adulto , Fatores Etários , Idoso , Betacoronavirus , Criança , Pré-Escolar , Comorbidade , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto Jovem
6.
BMC Infect Dis ; 20(1): 787, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33092539

RESUMO

BACKGROUND: A cluster of acute respiratory illness, now known as Corona Virus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged population with cardiovascular diseases are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases have a high prevalence in the middle-aged and elderly population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Therefore, a specific analysis in regard to cardiovascular implications of COVID-19 patients is in great need. METHODS: In this single-centered, retrospective, observational study, 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases. RESULTS: Of 116 hospitalized patients with COVID-19, the median age was 58.5 years (IQR, 47.0-69.0), and 36 (31.0%) were female. Hypertension (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever [99 (85.3%)], dry cough (61 [52.6%]), fatigue (60 [51.7%]), dyspnea (52 [44.8%]), anorexia (50 [43.1%]), and chest discomfort (50 [43.1%]). Local and/or bilateral patchy shadowing were the typical radiological findings on chest computed tomography. Lymphopenia (lymphocyte count, 1.0 × 109/L [IQR, 0.7-1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3-319.8]) in 69 patients (59.5%). Hypokalemia occurred in 24 (20.7%) patients. Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0-76.0] vs 56.0 years [IQR, 37.0-64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence of new onset hypertension was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones. CONCLUSIONS: In this single-centered, retrospective, observational study, we found that the infection of SARS-CoV-2 was more likely to occur in middle and aged population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension and heart injury were common in severe patients with COVID-19. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease.


Assuntos
Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Idoso , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/patologia , Tosse/epidemiologia , Feminino , Febre/epidemiologia , Humanos , Linfopenia/epidemiologia , Linfopenia/patologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/patologia , Estudos Retrospectivos , Síndrome Respiratória Aguda Grave/epidemiologia
7.
BMC Infect Dis ; 20(1): 639, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867694

RESUMO

BACKGROUND: Dengue fever is an arthropod vector-borne disease transmitted to humans by infected Aedes mosquitoes. Ethiopia has a favorable ecology for arthropods and report high burden of acute febrile illnesses. However, the contribution of arboviral infections to the burden of acute febrile illnesses is barely known. In this study the seropositivity to dengue virus infection and associated risk factors were assessed in Arba Minch districts, southern Ethiopia. METHODS: An institution based cross-sectional study was conducted in a consecutive group of 529 acute febrile patients between May to August 2016. Socio-demographic data, residence place and clinical signs and symptoms were collected using structured questionnaires. Sera were tested for anti-dengue IgG and IgM using Euroimmune indirect immunofluorescent assay. Data analysis was done using SPSS V-20 (IBM Corp, 2012). P-value < 0.05 was taken as statistically significant. RESULT: Seropositivity was 25.1% (133/529) and 8.1% (43/529) for anti- IgG and IgM respectively. CONCLUSION: The high IgM prevalence detected indicate the probability of active transmission with a potential of public health significance that calls for a proactive follow up of the communities in the study area to forecast and avert the risk.


Assuntos
Anticorpos Antivirais/sangue , Vírus da Dengue/imunologia , Dengue/sangue , Dengue/epidemiologia , Febre/sangue , Febre/epidemiologia , Adolescente , Adulto , Animais , Estudos Transversais , Dengue/diagnóstico , Dengue/virologia , Etiópia/epidemiologia , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
8.
BMC Infect Dis ; 20(1): 640, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867706

RESUMO

BACKGROUND: The COVID-19 pandemic has affected the world deeply, with more than 14,000,000 people infected and nearly 600,000 deaths. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic. METHODS: We scoped for relevant literatures published during 1st December 2019 to 16th July 2020 based on three databases using English and Chinese languages. We reviewed and analyzed the relevant outcomes. RESULTS: The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24-3.39), the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0 °C), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 °C, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 65 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region. CONCLUSIONS: We provided a bird's-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease's future research, control and prevention.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Linfopenia/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Síndrome do Desconforto Respiratório do Adulto/epidemiologia , Fatores Etários , Idoso , Comorbidade , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/transmissão , Tosse/epidemiologia , Demografia , Progressão da Doença , Dispneia/epidemiologia , Fadiga/epidemiologia , Feminino , Febre/epidemiologia , Humanos , Laboratórios , Masculino , Pneumonia Viral/mortalidade , Pneumonia Viral/patologia , Pneumonia Viral/transmissão , Fatores de Risco , Fatores Sexuais , Tomografia Computadorizada por Raios X
9.
J Korean Med Sci ; 35(37): e333, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32959547

RESUMO

BACKGROUND: There is limited information on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who are asymptomatic or have mild symptoms. METHODS: We performed a retrospective case series of patients with COVID-19 enrolled from February 22 to March 26, 2020. Forty cases of COVID-19 were confirmed using real-time reverse-transcription polymerase chain reaction among patients who underwent screening tests and were consecutively hospitalized at Ulsan University Hospital, Ulsan, Korea. The final follow-up date was May 19, 2020. All COVID-19 cases in Ulsan were included. Demographic and epidemiological information, comorbidities, clinical signs and symptoms, laboratory and radiologic findings, medications, treatments, outcomes, and main durations of patients with COVID-19 were compared according to supplemental oxygen requirement. RESULTS: Forty patients were included (median age, 30 years; interquartile range [IQR], 25-57 years; 58% female). Six (15%) patients required supplemental oxygen. The prevalence of asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection was 5% and that of presymptomatic infection was 13%. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea were the screening criteria for diagnosing symptomatic and presymptomatic SARS-CoV-2 infections. Sputum production, chest discomfort, a large number of symptoms, abnormal procalcitonin and C-reactive protein levels, and abnormal chest X-ray or chest computed tomography findings were more common in patients requiring supplemental oxygen than in those not requiring supplemental oxygen. Overall mortality rate was 3% (1/40). Four patients (10%) were readmitted after testing positive by reverse-transcription polymerase chain reaction again. Incubation period was 5 days (IQR, 4-6 days), and the duration of viral shedding was 21 days (IQR, 14-28 days; maximum, 51 days). CONCLUSION: The prevalence of asymptomatic SARS-CoV-2 infection was 5%, which is much lower than that previously reported. This finding suggests that careful interviews and follow-ups should be performed to identify SARS-CoV-2 infections. Cough, fever, myalgia, rhinorrhea or nasal congestion, and diarrhea are adequate screening criteria for covering all symptoms of SARS-CoV-2 infection. Further evaluation is required to create representative screening criteria for COVID-19.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Idoso , Betacoronavirus , Comorbidade , Tosse/epidemiologia , Diarreia/epidemiologia , Feminino , Febre/epidemiologia , Hospitalização , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Mialgia/epidemiologia , Pandemias , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Avaliação de Sintomas , Resultado do Tratamento
10.
Ren Fail ; 42(1): 950-957, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32924707

RESUMO

BACKGROUND: Novel coronavirus disease (COVID-19) is spreading rapidly, which poses great challenges to patients on maintenance hemodialysis. Here we report the clinical features of 66 hemodialysis patients with laboratory confirmed COVID-19 infection. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Retrospective, single-center case series of the 66 hemodialysis patients with confirmed COVID-19 from 1 January to 5 March 2020; the final date of follow-up was 25 March 2020. RESULTS: The clinical data were collected from 66 hemodialysis patients with confirmed COVID-19. The incidence of COVID-19 in our center was 11.0% (66/602), of which 18 patients died. According to different prognosis, hemodialysis patients with COVID-19 were divided into the survival and death group. A higher incidence of fever and dyspnea was found in the death group compared with the survival group. Meanwhile, patients in the death group were often accompanied by higher white blood cell count, prolonged PT time, increased D-dimer (p < .05). More patients in the death group showed hepatocytes and cardiomyocytes damage. Furthermore, logistic regression analysis suggested that fever, dyspnea, and elevated D-dimer were independent risk factors for death in hemodialysis patients with COVID-19 (OR, 1.077; 95% CI, 1.014 to 1.439; p = .044; OR, 1.146; 95% CI, 1.026 to 1.875; p = .034, OR, 4.974; 95% CI, 3.315 to 6.263; p = .007, respectively). CONCLUSIONS: The potential risk factors of fever, dyspnea, and elevated D-dimer could help clinicians to identify hemodialysis patients with poor prognosis at an early stage of COVID-19 infection.


Assuntos
Infecções por Coronavirus , Dispneia , Febre , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Falência Renal Crônica , Pandemias , Pneumonia Viral , Medição de Risco/métodos , Betacoronavirus/isolamento & purificação , China/epidemiologia , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Dispneia/diagnóstico , Dispneia/epidemiologia , Feminino , Febre/diagnóstico , Febre/epidemiologia , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Mortalidade , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Prognóstico , Diálise Renal/métodos , Estudos Retrospectivos , Fatores de Risco
11.
Rev Peru Med Exp Salud Publica ; 37(2): 253-258, 2020.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-32876213

RESUMO

In order to describe manifestations from patients with coronavirus disease 2019 (COVID-19), sociodemographic variables such as, previous medical history, clinical and radiological manifestations, treatments and evolution of patients were evaluated. This took place from March 6th to 25th, 2020, in the "Edgardo Rebagliati Martins" National Hospital in Lima. Seventeen patients were registered: 76% were male, with an average age of 53.5 years (range 25-94); 23.5% had returned from abroad; 41.2% were referred from other health facilities; 41.2% were admitted to mechanical ventilation; 29.4% (5 patients) died. The risk factors detected were: advanced age, arterial hypertension and obesity. The main symptoms detected were: cough, fever and dyspnea. Frequent laboratory findings were: elevated C-reactive protein and lymphopenia. The predominant radiological presentation was bilateral interstitial lung infiltrate. A first experience in the management of patients diagnosed with severe COVID-19 in Peru is reported.


Assuntos
Infecções por Coronavirus/fisiopatologia , Hospitalização , Pneumonia Viral/fisiopatologia , Respiração Artificial , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Tosse/epidemiologia , Tosse/etiologia , Dispneia/epidemiologia , Dispneia/etiologia , Feminino , Febre/epidemiologia , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Peru , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
12.
Rev Peru Med Exp Salud Publica ; 37(2): 335-340, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32876226

RESUMO

COVID-19 is rarely reported in children and they are mildly affected in most cases. The most common clinical presentation of COVID-19 is cough, fever and sore throat; severe cases show tachypnea. The course of the disease is from one to two weeks. Laboratory findings are nonspecific; lymphopenia, elevation of C-reactive protein and procalcitonin have been described. Early chest X-ray is usually normal, and the most common tomographic findings are consolidations with halo, ground-glass opacities and tiny nodules which mainly affects subpleural areas. Management of the disease is supportive; in severe cases, it should be focused on respiratory support. It is recommended to limit the handling of respiratory secretions and to follow the same preventive measures provided to adults.


Assuntos
Infecções por Coronavirus/epidemiologia , Tosse/epidemiologia , Febre/epidemiologia , Pneumonia Viral/epidemiologia , Fatores Etários , Criança , Infecções por Coronavirus/fisiopatologia , Tosse/virologia , Febre/virologia , Humanos , Pandemias , Faringite/epidemiologia , Faringite/virologia , Pneumonia Viral/fisiopatologia , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
13.
Anaesthesia ; 75(12): 1614-1619, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32777861

RESUMO

COVID-19, the respiratory disease caused by SARS-CoV-2, is thought to cause a milder illness in pregnancy with a greater proportion of asymptomatic carriers. This has important implications for the risk of patient-to-staff, staff-to-staff and staff-to-patient transmission among health professionals in maternity units. The aim of this study was to investigate the prevalence of previously undiagnosed SARS-CoV-2 infection in health professionals from two tertiary-level maternity units in London, UK, and to determine associations between healthcare workers' characteristics, reported symptoms and serological evidence of prior SARS-CoV-2 infection. In total, 200 anaesthetists, midwives and obstetricians, with no previously confirmed diagnosis of COVID-19, were tested for immune seroconversion using laboratory IgG assays. Comprehensive symptom and medical histories were also collected. Five out of 40 (12.5%; 95%CI 4.2-26.8%) anaesthetists, 7/52 (13.5%; 95%CI 5.6-25.8%) obstetricians and 17/108 (15.7%; 95%CI 9.5-24.0%) midwives were seropositive, with an overall total of 29/200 (14.5%; 95%CI 9.9-20.1%) of maternity healthcare workers testing positive for IgG antibodies against SARS-CoV-2. Of those who had seroconverted, 10/29 (35.5%) were completely asymptomatic. Fever or cough were only present in 6/29 (21%) and 10/29 (35%) respectively. Anosmia was the most common symptom occurring in 15/29 (52%) seropositive participants and was the only symptom that was predictive of positive seroconversion (OR 18; 95%CI 6-55). Of those who were seropositive, 59% had not self-isolated at any point and continued to provide patient care in the hospital setting. This is the largest study of baseline immune seroconversion in maternity healthcare workers conducted to date and reveals that one out of six were seropositive, of whom one out of three were asymptomatic. This has significant implications for the risk of occupational transmission of SARS-CoV-2 for both staff and patients in maternity units. Regular testing of staff, including asymptomatic staff should be considered to reduce transmission risk.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etiologia , Pessoal de Saúde/estatística & dados numéricos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Obstetrícia , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Adulto , Idoso , Anestesistas , Infecções por Coronavirus/imunologia , Tosse/epidemiologia , Tosse/etiologia , Estudos Transversais , Feminino , Febre/epidemiologia , Febre/etiologia , Humanos , Imunoglobulina G/imunologia , Transmissão de Doença Infecciosa do Profissional para o Paciente/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Tocologia , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/etiologia , Pandemias , Médicos , Pneumonia Viral/imunologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Soroconversão , Adulto Jovem
14.
Medwave ; 20(7): e7994, 2020 Aug 13.
Artigo em Espanhol | MEDLINE | ID: mdl-32804922

RESUMO

Introduction: Health personnel, including physicians, are a fundamental part of the first line of defense against the SARS-CoV-2 pandemic. Objective: To characterize the clinical manifestations and course of the first cases of contagion by SARS-CoV-2 in doctors of Peru. Methodology: We present a series of six cases of doctors infected by SARS-CoV-2, with confirmed positivity for COVID-19, showing the daily evolution from the diagnosis of the disease, its main signs and symptoms, evolution, and until the outcome in each case. Results: Five were men. The median age was 28 years (interquartile range: 27 to 33). In three cases the physician worked more than 12 hours a day in emergency and hospitalization services and not wear a mask at all times. The most frequent symptoms were axillary temperature above 38°C, malaise, dry cough, and odynophagia (the latter in three of the cases). The diagnosis was made at a median of 3 days (interquartile range: 3 to 4 days). The symptoms that persisted the most were dry cough (present during ten days in four doctors). Dysgeusia was the only symptom with the most extended duration (15 days in only one doctor). In the six cases, the course was favorable. However, these doctors found it difficult to return to functions in their hospital centers adequately. Discussion: Despite a small number of cases, it is the first report detailing the evolution of symptoms day by day, which can help for occupational health and even for case surveillance and monitoring.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/fisiopatologia , Transmissão de Doença Infecciosa do Paciente para o Profissional , Médicos , Pneumonia Viral/fisiopatologia , Adulto , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Tosse/epidemiologia , Tosse/virologia , Disgeusia/epidemiologia , Disgeusia/virologia , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Masculino , Máscaras/estatística & dados numéricos , Pandemias , Peru , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão
15.
Malawi Med J ; 32(1): 31-36, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32733657

RESUMO

Background: While health providers consistently use malaria rapid diagnostic tests to rule out malaria, they often lack tools to guide treatment for those febrile patients who test negative. Without the tools to provide an alternative diagnosis, providers may prescribe unnecessary antibiotics or miss a more serious condition, potentially contributing to antibiotic resistance and/or poor patient outcomes. Methods: This study ascertained which diagnoses and treatments might be associated with poor outcomes in adults who test negative for malaria. Adult patients for rapid diagnostic test of malaria seen in mobile health clinics in Mulanje and Phalombe districts were followed for 14 days. Participants were interviewed on sociodemographic characteristics, health-seeking behaviour, diagnosis, treatment and access to care. Mobile clinic medical charts were reviewed. Two weeks (±2 days) following clinic visit, follow-up interviews were conducted to assess whether symptoms had resolved. Results: Initially, 115 adult patients were enrolled and 1 (0.88%) was lost to follow-up. Of the 114 adult patients remaining in the study, 55 (48%) were seen during the dry season and 59 (52%) during the wet season. Symptoms resolved in 90 (80%) patients at the 14-day follow-up visit (n=90) with the rest (n=24) reporting no change in symptoms. None of the patients in the study died or were referred for further care. Almost all patients received some type of medication during their clinic visit (98.2%). Antibiotics were given to 38.6% of patients, and virtually all patients received pain or fever relief (96.5%). However, no anti-malarials were prescribed. Conclusions: Mobile clinics provide important health care where access to care is limited. Although rapid tests have guided appropriate treatment, challenges remain when a patient's presenting complaint is less well defined. In rural areas of southern Malawi, simple diagnostics are needed to guide treatment decisions.


Assuntos
Febre de Causa Desconhecida/epidemiologia , Febre/epidemiologia , Unidades Móveis de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Adulto , Assistência à Saúde , Feminino , Febre/etiologia , Seguimentos , Acesso aos Serviços de Saúde , Humanos , Malaui/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde
16.
BMC Infect Dis ; 20(1): 567, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746805

RESUMO

BACKGROUND: To assess the dynamic changes in clinical and CT characteristics of COVID-19 patients with different epidemiology histories. METHODS: Fifty-three discharged COVID-19 patients were enrolled at Beijing YouAn Hospital, Capital Medical University, between January 21 and March 10, 2020. Spearman correlation analysis was performed between CT scores and laboratory indicators. Patients were divided into the Wuhan group (lived in or with travel to Wuhan, numbering 30 cases) and non-Wuhan group (close contacts or unknown exposure, totaling 23 cases). The CT and laboratory findings were compared between and within groups during the clinical process. RESULTS: Fever (88.7%), cough (64.2%), fatigue (34%), and abnormal laboratory indicators, including lymphopenia, reduced albumin, albumin/globulin (A/G), and elevated C-reactive protein (CRP), were mainly observed. Subpleural ground-glass opacities (86.8%) were usually detected at admission. The CT scores were highly correlated with lymphocytes, CRP, albumin, and A/G at initial and follow-ups (all p < 0.05). Four days after admission, most patients (66.7% Wuhan, 47.8% non-Wuhan) showed progression, and the CT scores of Wuhan significantly increased (p = 0.015). Eight days after admission, the vast majority of patients (69.2% Wuhan, 100% non-Wuhan, p = 0.006) presented improvement, and the CT scores of non-Wuhan were significantly lower than Wuhan (p = 0.006). Pneumonia was completely absorbed in most patients 2-4 weeks after discharge. CONCLUSIONS: CT plays a crucial role in the early diagnosis and monitoring of changes in COVID-19. Lymphocytes, CRP, albumin, and A/G are expected to predict disease severity and prognosis. Viral pathogenicity in non-endemic areas may be weaker than core-infected areas. In most patients, lung lesions can disappear around 4 weeks after discharge.


Assuntos
Betacoronavirus , Proteína C-Reativa/análise , Infecções por Coronavirus/diagnóstico por imagem , Tosse/epidemiologia , Febre/epidemiologia , Linfopenia/diagnóstico , Pneumonia Viral/diagnóstico por imagem , Albumina Sérica Humana/análise , Soroglobulinas/análise , Adulto , Idoso , Infecções por Coronavirus/virologia , Tosse/virologia , Progressão da Doença , Feminino , Febre/virologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Alta do Paciente , Pneumonia Viral/virologia , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Viagem
17.
BMC Infect Dis ; 20(1): 564, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746801

RESUMO

BACKGROUND: The recent COVID-19 outbreak in Wuhan, China, has quickly spread throughout the world. In this study, we systematically reviewed the clinical features and outcomes of pregnant women with COVID-19. METHODS: PubMed, Web of Science, EMBASE and MEDLINE were searched from January 1, 2020, to April 16, 2020. Case reports and case series of pregnant women infected with SARS-CoV-2 were included. Two reviewers screened 366 studies and 14 studies were included. Four reviewers independently extracted the features from the studies. We used a random-effects model to analyse the incidence (P) and 95% confidence interval (95% CI). Heterogeneity was assessed using the I2 statistic. RESULTS: The meta-analysis included 236 pregnant women with COVID-19. The results were as follows: positive CT findings (71%; 95% CI, 0.49-0.93), caesarean section (65%; 95% CI, 0.42-0.87), fever (51%; 95% CI, 0.35-0.67), lymphopenia (49%; 95% CI, 0.29-0.70), coexisting disorders (33%; 95% CI, 0.21-0.44), cough (31%; 95% CI, 0.23-0.39), fetal distress (29%; 95% CI, 0.08-0.49), preterm labor (23%; 95% CI, 0.14-0.32), and severe case or death (12%; 95% CI, 0.03-0.20). The subgroup analysis showed that compared with non-pregnant patients, pregnant women with COVID-19 had significantly lower incidences of fever (pregnant women, 51%; non-pregnant patients, 91%; P < 0.00001) and cough (pregnant women, 31%; non-pregnant patients, 67%; P < 0.0001). CONCLUSIONS: The incidences of fever, cough and positive CT findings in pregnant women with COVID-19 are less than those in the normal population with COVID-19, but the rate of preterm labor is higher among pregnant with COVID-19 than among normal pregnant women. There is currently no evidence that COVID-19 can spread through vertical transmission.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Trabalho de Parto Prematuro/epidemiologia , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Cesárea , China/epidemiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/virologia , Tosse/epidemiologia , Tosse/virologia , Feminino , Febre/epidemiologia , Febre/virologia , Humanos , Incidência , Recém-Nascido , Transmissão Vertical de Doença Infecciosa , Trabalho de Parto Prematuro/virologia , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Complicações Infecciosas na Gravidez/virologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
18.
Pediatr Emerg Care ; 36(10): 500-504, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826642

RESUMO

In late March and early April, New York City was an epicenter of the COVID-19 pandemic. Citizens were ordered to stay at home to flatten the curve. The adult population was affected with a severe respiratory illness as well as acute kidney injury, cardiomyopathy, arrhythmia, and thromboembolism. Although children were not affected in the same manner, weeks after the peak, reports from other countries emerged about cases of pediatric patients presenting with a novel inflammatory syndrome. We present 4 patients along with their emergency department course, so providers will have a better understanding of the identification and workup of these patients. Currently, it is unclear when this inflammatory syndrome develops in respect to a COVID-19 infection. The clinical features of this syndrome seem to overlap between Kawasaki disease, toxic shock syndrome, and myocarditis. All patients presenting to our emergency department had fever, variable rash, abdominal pain, vomiting, and/or diarrhea. Patients remained persistently tachycardic and febrile despite being given proper doses of antipyretics. Severity of presentations varied among the 4 cases. All 4 patients were found to have antibodies to COVID-19. All patients required admission, but 2 required the pediatric intensive care unit for cardiac and/or respiratory support or closer monitoring. Upon follow-up on our patients, it seems that most patients are recovering with treatment, and overall, there is a low reported mortality rate.


Assuntos
Infecções por Coronavirus/diagnóstico , Pandemias , Pneumonia Viral/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Adolescente , Anti-Inflamatórios/uso terapêutico , Betacoronavirus , Criança , Pré-Escolar , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência , Feminino , Febre/epidemiologia , Hospitalização , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Unidades de Terapia Intensiva Pediátrica , Masculino , Cidade de Nova Iorque , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Respiração Artificial , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Resultado do Tratamento
19.
PLoS Med ; 17(8): e1003208, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32813708

RESUMO

BACKGROUND: The prescription rate of antibiotics is high for febrile children visiting the emergency department (ED), contributing to antimicrobial resistance. Large studies at European EDs covering diversity in antibiotic and broad-spectrum prescriptions in all febrile children are lacking. A better understanding of variability in antibiotic prescriptions in EDs and its relation with viral or bacterial disease is essential for the development and implementation of interventions to optimise antibiotic use. As part of the PERFORM (Personalised Risk assessment in Febrile illness to Optimise Real-life Management across the European Union) project, the MOFICHE (Management and Outcome of Fever in Children in Europe) study aims to investigate variation and appropriateness of antibiotic prescription in febrile children visiting EDs in Europe. METHODS AND FINDINGS: Between January 2017 and April 2018, data were prospectively collected on febrile children aged 0-18 years presenting to 12 EDs in 8 European countries (Austria, Germany, Greece, Latvia, the Netherlands [n = 3], Spain, Slovenia, United Kingdom [n = 3]). These EDs were based in university hospitals (n = 9) or large teaching hospitals (n = 3). Main outcomes were (1) antibiotic prescription rate; (2) the proportion of antibiotics that were broad-spectrum antibiotics; (3) the proportion of antibiotics of appropriate indication (presumed bacterial), inappropriate indication (presumed viral), or inconclusive indication (unknown bacterial/viral or other); (4) the proportion of oral antibiotics of inappropriate duration; and (5) the proportion of antibiotics that were guideline-concordant in uncomplicated urinary and upper and lower respiratory tract infections (RTIs). We determined variation of antibiotic prescription and broad-spectrum prescription by calculating standardised prescription rates using multilevel logistic regression and adjusted for general characteristics (e.g., age, sex, comorbidity, referral), disease severity (e.g., triage level, fever duration, presence of alarming signs), use and result of diagnostics, and focus and cause of infection. In this analysis of 35,650 children (median age 2.8 years, 55% male), overall antibiotic prescription rate was 31.9% (range across EDs: 22.4%-41.6%), and among those prescriptions, the broad-spectrum antibiotic prescription rate was 52.1% (range across EDs: 33.0%-90.3%). After standardisation, differences in antibiotic prescriptions ranged from 0.8 to 1.4, and the ratio between broad-spectrum and narrow-spectrum prescriptions ranged from 0.7 to 1.8 across EDs. Standardised antibiotic prescription rates varied for presumed bacterial infections (0.9 to 1.1), presumed viral infections (0.1 to 3.3), and infections of unknown cause (0.1 to 1.8). In all febrile children, antibiotic prescriptions were appropriate in 65.0% of prescriptions, inappropriate in 12.5% (range across EDs: 0.6%-29.3%), and inconclusive in 22.5% (range across EDs: 0.4%-60.8%). Prescriptions were of inappropriate duration in 20% of oral prescriptions (range across EDs: 4.4%-59.0%). Oral prescriptions were not concordant with the local guideline in 22.3% (range across EDs: 11.8%-47.3%) of prescriptions in uncomplicated RTIs and in 45.1% (range across EDs: 11.1%-100%) of prescriptions in uncomplicated urinary tract infections. A limitation of our study is that the included EDs are not representative of all febrile children attending EDs in that country. CONCLUSIONS: In this study, we observed wide variation between European EDs in prescriptions of antibiotics and broad-spectrum antibiotics in febrile children. Overall, one-third of prescriptions were inappropriate or inconclusive, with marked variation between EDs. Until better diagnostics are available to accurately differentiate between bacterial and viral aetiologies, implementation of antimicrobial stewardship guidelines across Europe is necessary to limit antimicrobial resistance.


Assuntos
Antibacterianos/administração & dosagem , Prescrições de Medicamentos , Farmacorresistência Bacteriana/efeitos dos fármacos , Serviço Hospitalar de Emergência/tendências , Febre/tratamento farmacológico , Febre/epidemiologia , Adolescente , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Criança , Pré-Escolar , Prescrições de Medicamentos/normas , Farmacorresistência Bacteriana/fisiologia , Serviço Hospitalar de Emergência/normas , Europa (Continente)/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos
20.
Scott Med J ; 65(4): 127-132, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32807018

RESUMO

BACKGROUND: The first case of a novel coronavirus (COVID-19) infection was detected in Wuhan, fever and respiratory symptoms have been frequently reported in patients infected with this virus. AIM: It was aimed to compare the symptoms of patients with COVID-19 positivity and patients without COVID-19 positivity hospitalized with suspicion of COVID-19. METHODS: Patients presenting to the Sakarya University Training and Research Hospital with suspicion of COVID-19 were included in the study. Samples were obtained from the patients and PCR tests were performed; the patients were grouped as COVID-19 positive and COVID-19 negative; these two groups were questioned for 15 symptoms and the results were compared. RESULTS: A total of 297 patients with suspicion of COVID-19 were included in the study. COVID-19 was positive in 143 patients and negative in 154 patients. The most common symptoms in the COVID-19 positive group were: cough (56.6%), weakness (56.6%), taste disorder (35.7%), myalgia (34.3%), and fever (33.6%); and in the COVID-19 negative group: cough (63%), weakness (45.5%), dyspnea (29.9%), headache (27.3%) and fever (24.7%). When these two groups were compared, taste disorder, smell disorder and diarrhea were significantly higher in the COVID-19 positive group (p = <0,00001, p = 0,00001 and p = 0,02). CONCLUSION: Our study showed that taste and smell disorders and diarrhea were important markers in COVID-19 infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/terapia , Tosse/epidemiologia , Tosse/virologia , Diarreia/epidemiologia , Diarreia/virologia , Feminino , Febre/epidemiologia , Febre/virologia , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/epidemiologia , Debilidade Muscular/virologia , Mialgia/epidemiologia , Mialgia/virologia , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/virologia , Pandemias , Pneumonia Viral/terapia , Estudos Retrospectivos , Avaliação de Sintomas , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/virologia , Turquia
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